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BackgroundAbuse against women in labor starts with subtle forms of discrimination that can turn into overt violence. Therefore it is crucial to work towards prevention and elimination of disrespect and ill-treatment in medical facility perinatal care in which staff allows such abuse.The aim of the study was to analyze the experiences of women related to perinatal care. Special emphasis was put on experiences that had traits indicating disrespectful and offensive care during childbirth in medical facilities providing perinatal care.MethodsThis was a cross-sectional survey. A questionnaire was prepared for respondents who gave birth in medical facilities. Information about the study was posted on the website of a non-governmental foundation dealing with projects aimed at improving perinatal care. The respondents gave online consent for processing the submitted data. 8378 questionnaires were submitted. The study was carried out between February 06 and March 20, 2018. The results were analyzed using the Chi-square independence test. The analysis was carried out at the significance level of 0.05 in Excel, R and SPSS.ResultsDuring their hospital stay, 81% of women in the study experienced violence or abuse from medical staff on at least one occasion. The most common abuse was having medical procedures without prior consent. Inappropriate comments made by staff related to their own or a woman’s situation were reported in 25% of situations, whilst 20% of women experienced nonchalant treatment. In the study 19.3% of women reported that the staff did not properly care for their intimacy and 1.7% of the respondents said that the worst treatment was related to feeling anonymous in the hospital.ConclusionsThe study shows that during Polish perinatal care women experience disrespectful and abusive care. Most abuse and disrespect involved violation of the right to privacy, the right to information, the right to equal treatment, and the right to freedom from violence. The low awareness of abuses and complaints reported in the study may result from women’s ignorance about relevant laws related to human rights.

Objective To assess risk factors for anxiety and depression among pregnant women during the COVID‐19 pandemic using Mind‐COVID, a prospective cross‐sectional study that compares outcomes in middle‐income economies and high‐income economies. Methods A total of 7102 pregnant women from 12 high‐income economies and nine middle‐income economies were included. The web‐based survey used two standardized instruments, General Anxiety Disorder‐7 (GAD‐7) and Patient Health Questionnaire–9 (PHQ‐9). Result Pregnant women in high‐income economies reported higher PHQ‐9 (0.18 standard deviation [SD], P < 0.001) and GAD‐7 (0.08 SD, P = 0.005) scores than those living in middle‐income economies. Multivariate regression analysis showed that increasing PHQ‐9 and GAD‐7 scales were associated with mental health problems during pregnancy and the need for psychiatric treatment before pregnancy. PHQ‐9 was associated with a feeling of burden related to restrictions in social distancing, and access to leisure activities. GAD‐7 scores were associated with a pregnancy‐related complication, fear of adverse outcomes in children related to COVID‐19, and feeling of burden related to finances. Conclusions According to this study, the imposed public health measures and hospital restrictions have left pregnant women more vulnerable during these difficult times. Adequate partner and family support during pregnancy and childbirth can be one of the most important protective factors against anxiety and depression, regardless of national economic status.

Background: Extended breastfeeding is rare in Poland, and lack of acceptance and understanding is often evident in public opinion. The ability to provide reliable information about breastfeeding beyond infancy depends on health professionals’ levels of knowledge and attitudes. They are considered by most parents in Poland to be authorities in the field of child nutrition. Research aims: To determine (1) the level of knowledge and the attitudes of Polish health professionals towards extended breastfeeding; (2) the relationship between personal breastfeeding experience and attitudes towards extended breastfeeding; and (3) the relationship between knowledge about breastfeeding beyond twelve months and attitudes towards breastfeeding beyond infancy. Methods: A one-group prospective, cross-sectional, self-report style survey was used. The convenience sample (N = 495) comprised gynaecologists, neonatologists and midwives. Data were collected via an online questionnaire and the results were analyzed with the use of descriptive statistics, a chi-square independence test, Fisher’s exact test, post-hoc testing, and two-part tables using SPSS. Results: Most of the respondents (76.7%; n = 384) had a low level of knowledge about the benefits of breastfeeding beyond twelve months and even emphasized that this nutritional choice could have negative impacts. There was a positive correlation (F = 105.847; p = < .01) between levels of knowledge and respondents’ attitudes towards breastfeeding beyond infancy. Attitudes were also influenced by the length of time respondents had breastfed. Conclusion: Healthcare providers have an insufficient level of knowledge about extended breastfeeding and need further education in this area.

To reduce the risk of infection of SARS-CoV-2 during commuting to the clinic or due to contact with medical staff, the American College of Obstetricians and Gynecologists has recommended arranging some appointments in the form of “telehealth”. The aim of the study was to assess the access to medical care in pregnancy during the SARS-CoV-2 pandemic and the role of telehealth in the implementation of prenatal care standards. This is a cross-sectional study. The study group included 618 women who were pregnant and/or gave birth in Poland during the COVID-19 pandemic. The majority of the participants experienced difficulties accessing medical care because of the pandemic. The correlation between this experience and the use of the hybrid healthcare model was established. The affiliation to public or private healthcare was irrelevant. There was no relationship between healthcare (private/public or in-person/hybrid) and implementation of the prenatal care standards. To ensure safe access to prenatal care for pregnant women, recommendations for a hybrid pregnancy management model should be created with detailed information regarding which appointments patients must be present for in-person and which can be conducted remotely. To reduce the risks associated with movement and interpersonal contact, all visits during which tests and screenings take place should be conducted in-person; other appointments can be arranged in the form of telehealth.

Background There is not enough data regarding practices and protocols on the dose of oxytocin administrated to women during labour. Empirical evidence indicates that compliance with the guidelines improves the quality of healthcare and reduces adverse effects. The study aimed to evaluate practices of oxytocin provision for labour induction and augmentation in two maternity units in Poland. Methods The article presents a prospective observational study. Data from 545 (n = 545) labours was collected in two maternity units. First, the total dose (the total amount of oxytocin provided from the beginning in the labour ward until delivery including the III and IV stage of labour) and cumulative dose of oxytocin (the amount of oxytocin given until the birth of the neonate) administered to women during labour was calculated. Then, the relationship between the cumulative dose of oxytocin and short term perinatal outcomes (mode of delivery, use of epidural anaesthesia, Apgar scores, birth weight and postpartum blood loss) was analysed. Finally, the compliance of oxytocin supply during labour with national guidelines in the following five criteria: medium, start dose, escalation rate, interval, the continuation of infusion after established labour was examined. Results The average cumulative dose of oxytocin administrated to women before birth was 4402 mU following labour induction and 2366 mU following labour augmentation. The actual administration of oxytocin deviated both from the unit and national guidelines in 93.6% of all observed labours (mainly because of continuation of infusion after established labour). We found no statistically significant correlation between the cumulative dose of oxytocin administered and mode of delivery, immediate postpartum blood loss or Apgar scores. There was no observed effect of cumulative dose oxytocin on short-term perinatal outcomes. The two units participating in the study had similar protocols and did not differ significantly in terms of total oxytocin dose, rates of induction and augmentation - the only observed difference was the mode of delivery. Conclusions The study showed no effect of the mean cumulative oxytocin dose on short-term perinatal outcomes and high rate of non-compliance of the practice of oxytocin administration for labour induction and augmentation with the national recommendations. Cooperation between different professional groups of maternity care providers should be considered in building national guidelines for maternity care.. Further studies investigating possible long-term effects of the meant cumulative dose of oxytocin and the reasons for non-compliance of practice with guidelines should be carried out.

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The labor experience and satisfaction with childbirth are affected by the care provided (external factors) and individual variables (internal factors). In this paper, we present a descriptive analysis that aims to indicate the strongest correlates of birth experience among a wide range of indicators. The study is a prospective, cross-sectional, self-report survey. It includes the experiences of women giving birth in public and private hospitals in Poland. The two main variables were birth experience and satisfaction with care. The analysis consists of three parts: data pre-processing and initial analysis, explorative investigation, and regression analysis. Among the 15 variables with the highest predictive value regarding birth experience were being informed by the medical personnel, communication, and birth environment. The most significant variables among 15 variables, with the highest predictive value regarding care, were those concerning support, information, and respectful care. The strongest predictor for both, birth experience and satisfaction with care, is the sense of information, with logit coefficients of 0.745 and 1.143, respectively, for birth experience and satisfaction (0.367 and 0.346 for standardized OLS coefficient). The findings demonstrate that by using explanatory variables, one can predict a woman’s description of her satisfaction with perinatal care received in the hospital. On the other hand, they do not have such a significant and robust influence on the birth experience examined by the variables. For both the birth experience and satisfaction with care, the sense of being informed is the highest predictor.